Individual provider Active NPI

Abbie Lynn Loughran, LMSW

  • Social Worker
  • New York, NY
National Provider Identifier
1114216215
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
075939-1 Issued in NY
Practice address
462 1St Ave
6 West Room 55
New York, NY 10016-9196
Phone
(212) 562-3645
Fax
(212) 562-3606
NPI assigned
Mar 30, 2011
Last updated
Mar 30, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 075939-1 NY Primary

Addresses

Primary practice location

462 1St Ave
6 West Room 55
New York, NY 10016-9196

Mailing address

117 Walbrooke Ave
Staten Island, NY 10301-2654
Phone (917) 626-0403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160517002538 NJ Practitioner - Clinical Social Worker 1557650314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Shore Psychological Healthcare LLCGroup PAC ID 6305846379, 15 clinicians

Practice addresses (Care Compare)

1945 Route 33
Neptune, NJ 07753-4859
Phone (732) 920-3434

58 Maple Ave
Red Bank, NJ 07701-1618
Phone (732) 920-3434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
075939-1NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shore Psychological Healthcare LLC CurrentSince Apr 20, 2016 Accepting new patients

Locations

220 Jack Martin Blvd
#E2
Brick, NJ 08724

58 Maple Ave
Red Bank, NJ 07701

1945 State Route 33
Wall Township, NJ 07753
Phone (732) 776-2333

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301443200000",
    "number": "1114216215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WALBROOKE AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012654",
            "telephone_number": "917-626-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "462 1ST AVE",
            "address_2": "6 WEST ROOM 55",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100169196",
            "telephone_number": "212-562-3645",
            "fax_number": "212-562-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUGHRAN",
        "first_name": "ABBIE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-30",
        "last_updated": "2011-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "075939-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.